US seeks to deny residency visa applicants with co-morbidities

The US Embassy, Queen's Park West, Port of Spain. FILE PHOTO -

APPLICANTS for US residency visas and green cards who have co-morbidities may find it tougher to get approval, following a US State Department directive to embassies around the world to screen people with health complications. Local health practitioners say sensitivity, balance and fairness are needed in enforcing this measure.

The policy is intended to protect the American public purse from the burden of providing health support to immigrants.

“Certain medical conditions, including, but not limited to, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions, can require hundreds of thousands of dollars’ worth of care. All of these can require expensive, long-term care,” the directive said.

According to CBS News, the cable also encourages visa officers to consider other conditions, like obesity, which it notes can cause asthma, sleep apnea, and high blood pressure, in their assessment of whether an immigrant could become a public charge and therefore should be denied entry into the US.

Spokespeople for the State Department did not immediately respond to a CBS News request for comment on the cable.

“Does the applicant have adequate financial resources to cover the costs of such care over his entire expected lifespan without seeking public cash assistance or long-term institutionalisation at government expense?” the directive added.

Haitian Bridge Alliance director Guerline Jozef, speaking to CMC, has condemned the directive, saying: “If this guidance is allowed to stand, no immigrant applying for a visa or green card will be safe.”

Diabetes Association president Dr Andrew Dhanoo, in a WhatsApp response to questions from Newsday on November 10, said the measure raises important considerations around fairness, feasibility, and ethics.

Andrew Dhanoo, president of the Diabetes Association of TT. - Photo by Janelle De Souza.

“I understand that the intent behind such a policy may be to reduce the potential healthcare burden posed by immigrants who may require extensive treatment, whether during a short stay or in the case of overstaying. In TT, for instance, a significant portion of our health budget is devoted to managing chronic conditions like diabetes, and this is a reality shared by many countries.

“The key question, however, is how such screening would be implemented in practice, whether through formal medical assessments or more subjective means. This raises important considerations around fairness, feasibility, and ethics.”

Wellnest Caribbean Mental Health Specialists Ltd managing director Dr Rishi Ramoutar, in an e-mail response to questions from Newsday, said linking visa eligibility to health conditions, including mental health, is a complex issue that needs to be approached with sensitivity and balance.

“While governments have a responsibility to protect public health and ensure that incoming residents can access appropriate care, it’s equally important that such policies do not unintentionally reinforce stigma or discrimination.”

He said mental health conditions were common and varied widely in severity.

“Many individuals living with these conditions lead stable, productive lives and contribute meaningfully to their communities. A diagnosis alone should not be seen as a barrier to opportunity.

“Ultimately, health-based immigration policies should be guided by fairness, compassion, and evidence while recognising both the practical realities of public health and the dignity of individuals living with chronic or mental health conditions.”

Messages and calls to Foreign Affairs Minister Sean Sobers and Health Minister Dr Lackram Bodoe went unanswered up to press time.

According to the Pan-American Health Organization, non-communicable diseases (NCDs) account for 62 per cent of deaths every year in TT. It said over half of population has at least three risk factors for NCDs.

The Health Ministry says NCDs continue to be a concern in TT because of a high and increasing prevalence of risk factors in the population. It said those include several modifiable behavioural risk factors such as unhealthy diets, obesity, unhealthy habits like smoking and excessive alcohol consumption and lack of physical activity. It said if left unchanged, these modifiable behaviours can lead to chronic NCDs such as diabetes, heart disease, high blood pressure and cancer.

This story has been updated to include additional details. See original post here.